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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant. Taking Mixtard And Metformin. Does Insulin Type Have To Be Changed?

I am 30yr with type2 dm. Now 28wks pregnant. Hba1c was 7 in june. Since last month my fasting is btwn 135-160. Plbs is 160- 200. I am off sugar. Exercise regularly. currently on mixtard30 hm 10 units twice a day and metformin 1g bd. Do I need to change type of insulin? What regime is good for glycemic control. Is detemir with actrapid Better?
Tue, 13 Aug 2013
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General & Family Physician,  's  Response
Hello,
You definitely need a better control of your blood sugar levels as they are still high.
It can definitely be achieved by increasing your dose of inj.MIXTARD by few units twice a day.Although recently inj.DETEMIR has been approved by US FDA for the treatment of gestational diabetes and is the first long acting basal insulin to have been approved.It has been put in category B which means not causing any harm to foetus.
I think there is no need to change the type of insulin and carry on with slightly increased doses of MIXTARD,however the best would be take the opinion of your treating doctor and abide by his instructions.
Thanks
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Diabetologist,  Dr. Pratap VGM's  Response
Dear sir/madam

Detemir is long acting insulin and Actrapid is a shorter acting insulin but mixtard is mixture of both two.

I think its better for you to continue the mixed insulin to continue both fasting and post prandial levels

Thanks
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Pregnant. Taking Mixtard And Metformin. Does Insulin Type Have To Be Changed?

Hello, You definitely need a better control of your blood sugar levels as they are still high. It can definitely be achieved by increasing your dose of inj.MIXTARD by few units twice a day.Although recently inj.DETEMIR has been approved by US FDA for the treatment of gestational diabetes and is the first long acting basal insulin to have been approved.It has been put in category B which means not causing any harm to foetus. I think there is no need to change the type of insulin and carry on with slightly increased doses of MIXTARD,however the best would be take the opinion of your treating doctor and abide by his instructions. Thanks